{"id":1948,"date":"2015-03-29T07:55:42","date_gmt":"2015-03-29T07:55:42","guid":{"rendered":"http:\/\/biomedpharmajournal.org\/?p=1948"},"modified":"2020-04-26T07:42:57","modified_gmt":"2020-04-26T07:42:57","slug":"maternal-leptin-and-glucose-effect-on-the-anthropometric-measurements-of-the-saudi-newborn","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol4no2\/maternal-leptin-and-glucose-effect-on-the-anthropometric-measurements-of-the-saudi-newborn\/","title":{"rendered":"Maternal Leptin and Glucose: Effect on the Anthropometric Measurements of the Saudi Newborn"},"content":{"rendered":"

Introduction <\/strong><\/p>\n

Leptin is the protein product of the obesity gene and is synthesised in the adipose tissues and placenta1-2. It seems to function as a link between adiposity, satiety and activity and regulates body weight and energy expenditure through central nervous system feedback mechanism3-4.\u00a0 Since its discovery in 1994, extensive studies have been carried out on leptin both in animals and humans and have provided new insight in weight regulation and obesity development5-6. Studies have shown that leptin synthesis starts in utero<\/em> and circulating leptin levels may provide a growth promoting signal for fetal development during late pregnancy [7]. Umbilical cord leptin levels are generally lower than adult levels [8-9] and play a role in regulation of infancy weight gain10-11.<\/p>\n

A strong correlation has been demonstrated between umbilical cord leptin concentration and birth-weight reflecting a close relationship between leptin, birth-weight and body fat mass in newborn infants12-15.\u00a0 Hence leptin is considered as a possible growth factor in intrauterine fetal development (16). Some studies report similar levels of leptin in male and female newborn infants9, while others show higher levels in female newborns compared to male newborns17-20. Other contradictory reports regarding effect of gender of the baby on the leptin level of the mother also exist in the literature18-20. It is shown that both leptin and insulin like growth factor are independent predictors of fetal growth21\u00a0and are low in pregnancies with growth restriction22-23. The umbilical cord leptin is restricted in several conditions and is considered as a marker of intrauterine growth restriction23. Variable leptin levels are reported in different pathological states such as diabetes mellitus and hypertension24-25. It is also regarded as a potential marker of placental insufficiency26.<\/p>\n

In an attempt to study maternal leptin and glucose levels at the time of delivery and to investigate correlation between maternal leptin level, umbilical cord leptin levels and anthropometric measures in the new born, we carried out this study on healthy Saudi mother\/baby pairs at the time of normal full term delivery.<\/p>\n

Materials and Methods<\/strong><\/p>\n

One hundred and fifty one (151) randomly selected healthy mother\/newborn pairs at delivery of full term infants were included in this study. The study was approved by the ethical committee of the institution. All females signed an inform consent. The age, parity, height (length of baby), weight was recorded and body mass index (BMI) was calculated using the formula:<\/p>\n

Ponderal index (wt\/ht3) (Kg\/m3) and ratio of weight (kg) \/ height (m) were also calculated for the baby.<\/p>\n

Ten ml blood was drawn by venepuncture from healthy females having normal deliveries of live born babies at full term. In addition, blood sample was collected from umbilical cord at birth, immediately after delivery from the placental end (discarding the first 2 mls) after early ligation of the cord and after raising the baby to the level of the placenta to avoid feto-placental transfusion and vice versa.<\/p>\n

The blood was centrifuged at 1000 RPM for ten minutes and the plasma was carefully removed from the cells and stored frozen at \u201370OC until required for analysis. Leptin level in the maternal plasma and umbilical cord plasma was determined by radioimmunoassay (RIA) using kits from Linco. Glucose was estimated using autoanalysers at KKUH hospital Lab.<\/p>\n

The data obtained were entered on the computers and analyzed using SPSS (version 15) program for windows. Correlations studies and regression analysis were carried out using the General Linear Model Program. The relationship between leptin and anthropometric parameters was assessed by Pearson\u2019s and Spearman correlation. Students \u2018t\u2019 test was applied to determine the significance of the difference between any two groups and between different parameters. P value < 0.05 was considered statistically significant.<\/p>\n

Results<\/strong><\/p>\n

Demographic details of the mothers are presented in Table 1. The gestational age, birth-weight, birth length of the newborns were 36 \u2013 42 weeks, 3.20 \u00b1 0.524 kg and 0.486 \u00b1 0.024 cm. The mean, standard deviation, standard error of the mean (SEM) values for maternal age, leptin, weight, height, BMI and glucose, umbilical cord leptin, baby\u2019s length, weight, BMI, wt\/ht and ponderal index are presented in Table 2.<\/p>\n

Table 1: Mother\u2019s Demographic Data<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n
No.<\/strong><\/td>\n154<\/strong><\/td>\n<\/tr>\n
Age (Yrs):<\/td>\n29.73 \u00b1 6.406 yrs<\/td>\n<\/tr>\n
Weight (kg):<\/td>\n73.36 \u00b1\u00a0 16.7 Kg<\/td>\n<\/tr>\n
Height (m):<\/td>\n1.54 \u00b1\u00a0 0.05<\/td>\n<\/tr>\n
BMI (kg\/m2):<\/td>\n30.6\u00a0 \u00b1\u00a0 7.47<\/td>\n<\/tr>\n
Parity:<\/td>\n3 \u00b1 2<\/td>\n<\/tr>\n
Gestational age (wks):<\/td>\n36 \u2013 42<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Table 2: Age, leptin and anthropometric measures in the mothers and their babies<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n
<\/td>\n<\/td>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Maternal<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\nBaby<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n<\/tr>\n
<\/td>\nAge<\/td>\nLeptin<\/td>\nHeight<\/td>\nWeight<\/td>\nBMI<\/td>\nGlucose<\/td>\nUmbelical<\/td>\nHeight<\/td>\nWeight<\/td>\nBMI<\/td>\nWt\/Ht<\/td>\nPonderal<\/td>\n<\/tr>\n
<\/td>\nYrs<\/td>\nng\/ml<\/td>\nm<\/td>\nKm<\/td>\nKg\/m2<\/td>\nMmol\/l<\/td>\nCord<\/td>\nm<\/td>\nKg<\/td>\nKg\/m2<\/td>\nKg\/m<\/td>\nIndex<\/td>\n<\/tr>\n
<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\nLeptin<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\nKg\/m3<\/td>\n<\/tr>\n
<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\nng\/ml<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
Mean<\/td>\n29.73<\/td>\n19.79<\/td>\n1.54<\/td>\n72.9<\/td>\n30.5<\/td>\n4.93<\/td>\n10.36<\/td>\n48.64<\/td>\n3.42<\/td>\n14.11<\/td>\n0.71<\/td>\n19.7<\/td>\n<\/tr>\n
SEM<\/td>\n0.47<\/td>\n1.11<\/td>\n0.088<\/td>\n1.4<\/td>\n0.63<\/td>\n0.208<\/td>\n0.8<\/td>\n0.61<\/td>\n0.18<\/td>\n0.72<\/td>\n0.04<\/td>\n0.216<\/td>\n<\/tr>\n
SD<\/td>\n6.4<\/td>\n13.84<\/td>\n0.1<\/td>\n17.6<\/td>\n7.5<\/td>\n1.8<\/td>\n10.08<\/td>\n7.86<\/td>\n2.34<\/td>\n9.3<\/td>\n0.05<\/td>\n2.78<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Mean value of leptin was significantly higher in the mothers compared to the cord blood leptin level and the difference in the level of leptin in maternal blood and the cord blood was highly significant (p<0.0001). In the mothers the lowest leptin level was 1.0 ng\/ml and highest was 64.6 ng\/ml compared to 0.6 ng\/ml and 49.0 ng\/ml, respectively, in the cord blood, as shown in the frequency distribution histogram (Figure 1). The male babies were separated from the female babies and the leptin levels and anthropometric values were separately analysed for each gender, and the results are presented in Table 3.\u00a0 No significant differences were seen in values of these parameters in male and female infants.<\/p>\n\n\n\n
\"Fig.<\/td>\nFig. 1: Frequency distribution histogram of (a) maternal leptin and (b) umbilical cord leptin<\/strong><\/p>\n

Click here to View figure<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n

Table 3: Levels of leptin and anthropometric<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
measures in male and female babies<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n<\/tr>\n
Babies<\/strong><\/td>\nSex of the baby<\/strong><\/td>\nMean<\/strong><\/td>\nSD<\/strong><\/td>\nSEM<\/strong><\/td>\nP*<\/strong><\/td>\n<\/tr>\n
Leptin<\/td>\nM<\/td>\n8.88<\/td>\n8.98<\/td>\n1.09<\/td>\nNS<\/td>\n<\/tr>\n
(ng\/ml)<\/td>\nF<\/td>\n11.66<\/td>\n10.95<\/td>\n1.2<\/td>\n<\/td>\n<\/tr>\n
Height<\/td>\nM<\/td>\n48.77<\/td>\n3.03<\/td>\n0.34<\/td>\nNS<\/td>\n<\/tr>\n
(Cm)<\/td>\nF<\/td>\n48.56<\/td>\n1.78<\/td>\n0.19<\/td>\n<\/td>\n<\/tr>\n
Weight<\/td>\nM<\/td>\n3.41<\/td>\n1.23<\/td>\n0.14<\/td>\nNS<\/td>\n<\/tr>\n
(Kg)<\/td>\nF<\/td>\n3.44<\/td>\n3.03<\/td>\n0.32<\/td>\n<\/td>\n<\/tr>\n
BMI<\/td>\nM<\/td>\n13.67<\/td>\n1.91<\/td>\n0.21<\/td>\nNS<\/td>\n<\/tr>\n
(Kg\/m2)<\/td>\nF<\/td>\n14.65<\/td>\n1.25<\/td>\n1.37<\/td>\n<\/td>\n<\/tr>\n
Wt\/ht<\/td>\nM<\/td>\n0.71<\/td>\n0.04<\/td>\n0.004<\/td>\nNS<\/td>\n<\/tr>\n
Kg\/m<\/td>\nF<\/td>\n0.71<\/td>\n0.062<\/td>\n0.006<\/td>\n<\/td>\n<\/tr>\n
Ponderal<\/td>\nM<\/td>\n20.08<\/td>\n2.64<\/td>\n0.3<\/td>\nNS<\/td>\n<\/tr>\n
Index(Kg\/m3)<\/td>\nF<\/td>\n19.37<\/td>\n2.89<\/td>\n0.311<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

*The difference in the results in the male and female babies is not statistically significant.<\/p>\n

Correlation studies were conducted and Pearson correlation coefficient was obtained between the maternal parameters, the umbilical cord leptin and the anthropometric variables of the baby and Table 4 presents the Pearson correlation coefficient (r) and p value between the different correlated parameters (p<0.05). Maternal age was seen as an important factor affecting the weight and BMI of the mother and umbilical cord leptin (r=0.229; p=0.005). Maternal leptin correlated positively with maternal weight, BMI, and umbilical cord leptin (p<0.0001). Figure 2 presents the positive and significant correlation between maternal and umbilical cord leptin (r=0.287; p=0.0001). No correlation was seen with any of the anthropometric measures of the baby. Maternal glucose correlated significantly with umbilical cord leptin and baby\u2019s weight, BMI and ponderal index. Figure 3 presents the significant increase in umbilical cord leptin level with increase in maternal glucose. The babies with the highest leptin were born to the mothers with high blood glucose level. Umbilical cord leptin showed a significant correlation with weight of the baby, weight\/height ratio and ponderal index (p <0.05).<\/p>\n

Table 4: Correlation between leptin, weight, glucose and BMI in mothers and their babies<\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n\n
Parameter<\/strong><\/td>\nSignifi-<\/strong><\/td>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Maternal<\/strong><\/td>\nUmbi<\/strong><\/td>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Baby<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\ncance<\/strong><\/td>\nLeptin<\/strong><\/td>\nWeight<\/strong><\/td>\nGlucose<\/strong><\/td>\nBMI<\/strong><\/td>\ncal<\/strong><\/td>\nWeight<\/strong><\/td>\nBMI<\/strong><\/td>\nWt\/ht<\/strong><\/td>\nPonderal<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\nng\/ml<\/strong><\/td>\nmmol\/l<\/strong><\/td>\nKg\/m\u00b2<\/strong><\/td>\nLeptin<\/strong><\/td>\ncord<\/strong><\/td>\nKg\/m2<\/strong><\/td>\nKg\/m2<\/strong><\/td>\nKg\/m<\/strong><\/td>\nIndex<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\nWeight<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\nKg<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\n\u00a0<\/strong><\/td>\nKg\/m3<\/strong><\/td>\n<\/tr>\n
Leptin<\/td>\nr<\/td>\n1<\/td>\n.310**<\/td>\n-0.164<\/td>\n.254**<\/td>\n.287**<\/td>\n-0.153<\/td>\n-0.096<\/td>\n0.075<\/td>\n-0.148<\/td>\n<\/tr>\n
ng\/ml<\/td>\np<\/td>\n<\/td>\n0<\/td>\n0.156<\/td>\n0.006<\/td>\n0<\/td>\n0.074<\/td>\n0.267<\/td>\n0.384<\/td>\n0.086<\/td>\n<\/tr>\n
Weight<\/td>\nr<\/td>\n.310**<\/td>\n1<\/td>\n-0.113<\/td>\n.940**<\/td>\n0.151<\/td>\n.238**<\/td>\n.209*<\/td>\n0.048<\/td>\n.216*<\/td>\n<\/tr>\n
Kg<\/td>\np<\/td>\n0<\/td>\n<\/td>\n0.361<\/td>\n0<\/td>\n0.083<\/td>\n0.004<\/td>\n0.013<\/td>\n0.573<\/td>\n0.011<\/td>\n<\/tr>\n
Glucose<\/td>\nr<\/td>\n-0.164<\/td>\n-0.113<\/td>\n1<\/td>\n-0.077<\/td>\n.435**<\/td>\n.307**<\/td>\n.334**<\/td>\n0.113<\/td>\n.324**<\/td>\n<\/tr>\n
mmol\/l<\/td>\np<\/td>\n0.156<\/td>\n0.361<\/td>\n<\/td>\n0.568<\/td>\n0<\/td>\n0.008<\/td>\n0.004<\/td>\n0.341<\/td>\n0.005<\/td>\n<\/tr>\n
BMI<\/td>\nr<\/td>\n.254**<\/td>\n.940**<\/td>\n-0.077<\/td>\n1<\/td>\n0.109<\/td>\n.209*<\/td>\n.195*<\/td>\n0.001<\/td>\n.193*<\/td>\n<\/tr>\n
Kg\/m2<\/td>\np<\/td>\n0.006<\/td>\n0<\/td>\n0.568<\/td>\n<\/td>\n0.24<\/td>\n0.017<\/td>\n0.03<\/td>\n0.991<\/td>\n0.031<\/td>\n<\/tr>\n
Umbilical<\/td>\nr<\/td>\n.287**<\/td>\n0.151<\/td>\n.435**<\/td>\n0.109<\/td>\n1<\/td>\n.330**<\/td>\n0.166<\/td>\n.182*<\/td>\n.209*<\/td>\n<\/tr>\n
cord<\/td>\np<\/td>\n0<\/td>\n0.083<\/td>\n0<\/td>\n0.24<\/td>\n<\/td>\n0<\/td>\n0.055<\/td>\n0.034<\/td>\n0.015<\/td>\n<\/tr>\n
Leptin<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
ng\/ml<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
Baby<\/td>\nr<\/td>\n-0.153<\/td>\n.238**<\/td>\n.307**<\/td>\n.209*<\/td>\n.330**<\/td>\n1<\/td>\n.779**<\/td>\n.182*<\/td>\n.936**<\/td>\n<\/tr>\n
Weight<\/td>\np<\/td>\n0.074<\/td>\n0.004<\/td>\n0.008<\/td>\n0.017<\/td>\n0<\/td>\n<\/td>\n0<\/td>\n0.019<\/td>\n0<\/td>\n<\/tr>\n
Baby<\/td>\nr<\/td>\n-0.096<\/td>\n.209*<\/td>\n.334**<\/td>\n.195*<\/td>\n0.166<\/td>\n.779**<\/td>\n1<\/td>\n0.035<\/td>\n.942**<\/td>\n<\/tr>\n
BMI<\/td>\np<\/td>\n0.267<\/td>\n0.013<\/td>\n0.004<\/td>\n0.03<\/td>\n0.055<\/td>\n0<\/td>\n<\/td>\n0.652<\/td>\n0<\/td>\n<\/tr>\n
Kg\/m2<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
Baby<\/td>\nr<\/td>\n0.075<\/td>\n0.048<\/td>\n0.113<\/td>\n0.001<\/td>\n.182*<\/td>\n.182*<\/td>\n0.035<\/td>\n1<\/td>\n0.05<\/td>\n<\/tr>\n
Wt\/ht<\/td>\np<\/td>\n0.384<\/td>\n0.573<\/td>\n0.341<\/td>\n0.991<\/td>\n0.034<\/td>\n0.019<\/td>\n0.652<\/td>\n<\/td>\n0.524<\/td>\n<\/tr>\n
Kg\/m<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n
Baby<\/td>\nr<\/td>\n-0.148<\/td>\n.216*<\/td>\n.324**<\/td>\n.193*<\/td>\n.209*<\/td>\n.936**<\/td>\n.942**<\/td>\n0.05<\/td>\n1<\/td>\n<\/tr>\n
Ponderal<\/td>\np<\/td>\n0.086<\/td>\n0.011<\/td>\n0.005<\/td>\n0.031<\/td>\n0.015<\/td>\n0<\/td>\n0<\/td>\n0.524<\/td>\n<\/td>\n<\/tr>\n
IndexKg\/m3<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

*Statistically significant
\nr = Pearson correlation coefficient<\/p>\n\n\n\n
\"Fig.<\/td>\nFig. 2: Correlation between maternal and umbilical cord leptin<\/strong><\/p>\n

Click here to View figure<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

 <\/p>\n\n\n\n
\"Fig.<\/td>\nFig. 3: Correlation between maternal glucose and babies BMI<\/strong><\/p>\n

Click here to View figure<\/a><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Mothers who delivered male babies (no.= 68) were separated from those who delivered female babies (no.=83) and leptin level in the two groups was calculated separately (Table 5). The former group had slightly higher mean leptin (20.53 ng\/ml) compared to the latter (19.13 ng\/ml) but the difference was not statistically significant (p>0.05).<\/p>\n

\u00a0Table 5: Value of maternal leptin, weight, BMI and glucose <\/strong><\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
Maternal<\/strong><\/td>\nSex of<\/strong><\/td>\n\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Maternal values<\/strong><\/td>\n\u00a0<\/strong><\/td>\n<\/tr>\n
\u00a0<\/strong><\/td>\nthe baby<\/strong><\/td>\nMean<\/strong><\/td>\nSD<\/strong><\/td>\nSEM<\/strong><\/td>\nP value<\/strong><\/td>\n<\/tr>\n
Leptin<\/td>\nM<\/td>\n20.53<\/td>\n12.61<\/td>\n1.53<\/td>\nNS<\/td>\n<\/tr>\n
(ng\/ml)<\/td>\nF<\/td>\n19.13<\/td>\n14.84<\/td>\n1.63<\/td>\n<\/td>\n<\/tr>\n
Weight<\/td>\nM<\/td>\n76.82<\/td>\n14.96<\/td>\n1.83<\/td>\n0.02<\/td>\n<\/tr>\n
(Kg)<\/td>\nF<\/td>\n70.57<\/td>\n17.82<\/td>\n1.93<\/td>\n<\/td>\n<\/tr>\n
Glucose<\/td>\nM<\/td>\n4.6<\/td>\n0.88<\/td>\n0.16<\/td>\nNS<\/td>\n<\/tr>\n
(mmol\/l)<\/td>\nF<\/td>\n5.19<\/td>\n2.28<\/td>\n0.34<\/td>\n<\/td>\n<\/tr>\n
BMI<\/td>\nM<\/td>\n32.39<\/td>\n7.29<\/td>\n0.94<\/td>\n0.015<\/td>\n<\/tr>\n
(Kg\/m2)<\/td>\nF<\/td>\n29.28<\/td>\n7.45<\/td>\n0.84<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Discussion<\/strong><\/p>\n

During the last decade several studies have been carried out on umbilical cord leptin in an attempt to elucidate its role in fetal growth and development 8,11-14. All studies have shown that leptin is present in umbilical cord blood and its levels vary depending on several factors.\u00a0 These include the fetal body weight27, ponderal index28, BMI29, fetal gender18,20,28, and maternal illnesses24,25,30,31. Several studies have shown that the level of umbilical cord leptin is significantly lower than the maternal leptin10, though a few studies have reported umbilical cord leptin level to be the same as adult level32. Our study on healthy Saudi full-term maternal\/baby pairs has confirmed the presence of leptin in umbilical cord blood which shows a wide range of distribution both in maternal plasma and umbilical cord sample. This study has also shown that the mean umbilical cord leptin is significantly lower compared to the maternal leptin level (p<0.0001) and there is a statistically significant positive correlation between the maternal and umbilical cord leptin.\u00a0 Studies report that leptin level increases in maternal blood during pregnancy and plays an important role in providing a growth-promoting signal for fetal growth and metabolism and fetal fat mass during pregnancy19,20,33,34. In addition, it is confirmed that placenta is one of the major sources of leptin production, however, the level of leptin in umbilico-placental circulation is independent of the weight of placenta10,29,35.\u00a0 It has been suggested that during pregnancy, placental production of leptin is one major source of higher levels in maternal circulating leptin other than maternal gain of fat mass34. Data obtained in pregnant females has reinforced the idea that circulating leptin may provide a growth promoting signal for fetal development during late pregnancy10\u00a0and that an \u2018adipo-insular axis\u2019 exists and is functional before 34 weeks of gestation35.The results of this study show a close and statistically significant correlation between umbilical cord leptin and the birth weight, weight\/height ratio, ponderal index of the baby. However, no differences were seen in the umbilical cord leptin level of the male and female babies. This is in agreement with several other studies that report no gender differences at birth in leptin levels37-39, though in some studies newborn females have been reported to have higher cord blood leptin compared to the male newborns17,18, 20,39,40. Hytinantti et al.,<\/em>30\u00a0showed that leptin correlates with adiposity at birth in females, but not in male newborn infants. This led to the suggestion that sexual dimorphism in adipose tissues already exists in intero<\/em>28. In adult females there is significantly higher leptin levels compared to the males and extent of adiposity and BMI seem to be important determinants of adult leptin level41. However, it is not clear why in some studies there are no differences in the leptin levels of umbilical cord blood of male and female newborns, while in others the difference is statistically significant. This point requires further more carefully controlled larger investigations to identify the possible factors which predispose to such differences in different studies.\u00a0 In addition, there are reports in literature, of differences in leptin levels of mothers depending on the gender of the baby38. In this study on Saudis, we did not encounter any difference in the maternal leptin level depending on the gender of the baby. This point also requires further clarification.The umbilical cord leptin levels are reported to be higher in large for gestational age infants compared to the appropriate for gestational age infants41-44\u00a0and it is suggested that fatness of the fetus is the major determinant of circulating leptin levels45. In addition, it is confirmed that circulating leptin concentration relates to the intrauterine growth pattern. A very high umbilical cord leptin has been considered as an independent risk factor for fetal macrosomia46.\u00a0 In our study there were 2 babies over 4 kg in weight and their leptin levels were significantly higher (>25 ng\/ml) than the infants less then 4 kg in weight.Maternal health also plays a role in altering umbilical cord leptin level, where higher leptin levels have been demonstrated in the newborn infants of diabetic mothers and mothers with preeclampsia24,25,30,31, thus suggesting that any condition leading to intrauterine growth changes would also result in variation in umbilical cord leptin levels47. Interestingly, glucose level in the maternal plasma showed a significant correlation with umbilical cord leptin, baby weight, BMI and ponderal Index. Though the women included in this study were now diabetic, but elevation was glucose occurred in some near the time of delivery and this glucose level showed a significant correlation with the anthropometric measures in the baby.In this study we correlated the maternal leptin level in healthy females with the umbilical cord leptin, and observed a positive correlation. This finding is in disagreement with some of the previous reports which show that maternal leptin does not correlate with umbilical leptin level10,38. However, maternal leptin level can be considered as a reliable marker of fetal growth, while umbilical cord leptin correlates positively with fetal growth in all studies reported so far11.\u00a0\u00a0 The lack of correlation between maternal and cord blood leptin level seen in some studies had led to a hypothesis of a non-communicating, two compartment model of feto-placental leptin regulation, which our study refutes.In conclusion, the results of our study refute the hypothesis of a non-communicating two-compartment model of feto-placental leptin regulation and shows that umbilical cord leptin level correlates with maternal leptin level significantly. In addition, the in utero<\/em> production of leptin is not influenced by the gender of the baby, but correlates positively with birth weight, height, BMI and ponderal index of the baby.\u00a0 Thus, both umbilical cord leptin, and the maternal leptin, may be an important factor for growth of the fetus.<\/p>\n

Acknowledgements<\/strong><\/p>\n

The authors extend their appreciation to the Deanship of Scientific Research at King Saud University for funding the work through the research group project No. RGP-VPP-068″<\/p>\n

Disclosure of Competing Interests<\/strong><\/p>\n

Authors declare that they do not have any competing interests with any group.<\/p>\n

Authors\u2019 Contributions<\/strong>1<\/sup><\/p>\n

ASW designed the experiment, analyzed the data and wrote the manuscript. 2<\/sup>ZB and MA collected samples from their patients and contributed to discussion of results and preparation of the manuscript. SD and MA helped in data analysis, discussion of results and preparation of the manuscript. All authors read and approved the final manuscript.<\/p>\n

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       <\/p>\n

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